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2
Boonstra E, Lindbaek M, Fidzani B, Bruusgaard D, 2001. Cattle eradication and malnutrition in under five’s: a natural experiment in Botswana. Public Health Nutr 4 :877–882.
-
3
Ismail S, 1991. Nutritional surveillance: experience from developing countries. Proc Nutr Soc 50 :673–679.
-
4
Grivetti LE, 1978. Nutritional success in a semi-arid land: examination of Tswana agro-pastoralists of the eastern Kalahari, Botswana. Am J Clin Nutr 31 :1204–1220.
-
5
UNDP, 2003. Human Development Report 2003. New York: Oxford University Press.
-
6
Lemeshow S, Robinson D, 1985. Surveys to measure programme coverage and impact: a review of the methodology used by the expanded programme on immunization. World Health Stat Q 38 :65–75.
-
7
Hoshaw-Woodard S, 2001. Description and Comparison of the Methods of Cluster Sampling and Lot Quality Assurance Sampling to Assess Immunization Coverage. Geneva: World Health Organization.
-
8
World Health Organization, 2005. The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. Fourth edition. Geneva: World Health Organization.
-
9
World Health Organization, 1995. Physical Status: The Use and Interpretation of Anthropometry. Geneva: World Health Organization.
-
10
American Public Health Association, American Water Works Association, Water Pollution Control Federation, 1980. Standard Methods for the Examination of Water and Wastewater. 15th edition. Washington, DC: American Public Health Association.
-
11
Olson B, Clark D, Milner B, Stewart M, Wolfe R, 1991. Total coliform detection in drinking water: comparison of membrane filtration with Colilert and Coliquick. Appl Environ Microbiol 57 :1535–1539.
-
12
Alam NHF, Rahaman MM, 1989. Reporting errors in one-week diarrhoea recall surveys: experience from a prospective study in rural Bangladesh. Int J Epidemiol 18 :697–700.
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13
Ramakrishnan RVT, Koya PK, Kamaraj P, 1999. Influence of recall period on estimates of diarrhoea morbidity in infants in rural Tamilnadu. Indian J Public Health 43 :136–139.
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14
Genser B, Strina A, Teles CA, Prado MS, Barreto ML, 2006. Risk factors for childhood diarrhea incidence: dynamic analysis of a longitudinal study. Epidemiology 17 :658–667.
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15
Molbak K, Aaby P, Hojlyng N, da Silva AP, 1994. Risk factors for Cryptosporidium diarrhea in early childhood: a case-control study from Guinea-Bissau, West Africa. Am J Epidemiol 139 :734–740.
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16
Rose JB, 1997. Environmental ecology of Cryptosporidium and public health implications. Annu Rev Public Health 18 :135–161.
-
17
Thomson MC, Mason SJ, Phindela T, Connor SJ, 2005. Use of rainfall and sea surface temperature monitoring for malaria early warning in Botswana. Am J Trop Med Hyg 73 :214–221.
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18
Schmitt CV, 2006. Africa Weather Hazards Assessment February 2–8, 2006. Famine Early Warning System Network.
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19
Leshomo K, 2006. Diarrhea Epidemic Leads to Threat of Severe Malnutrition in Botswana. New Yok: UNICEF.
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20
Southern African Development Community Food Agricultural and Natural Resources Directorate, 2006. Agromet-Update: 2005/2006 Agricultural Season. Food Security Early Warning System.
-
21
Dop MC, 2002. Breastfeeding in Africa: will positive trends be challenged by the AIDS epidemic? [in French]. Sante 12 :64–72.
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22
UNICEF, 2000. Botswana Multiple Indicator Survey. New York: The United Nations Children’s Fund.
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23
Gracey M, 1996. Diarrhea and malnutrition: a challenge for pediatricians. J Pediatr Gastroenterol Nutr 22 :6–16.
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24
The Sphere Project, 2004. Humanitarian Charter and Minimum Standards in Disaster Response. Geneva: Oxfam Publishing.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 325 | 230 | 6 |
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Population-Based Study of a Widespread Outbreak of Diarrhea Associated with Increased Mortality and Malnutrition in Botswana, January–March, 2006
Ondrej Mach
Ondrej Mach
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Lydia Lu
Lydia Lu
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Tracy Creek
Tracy Creek
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Anna Bowen
Anna Bowen
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Wences Arvelo
Wences Arvelo
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Molly Smit
Molly Smit
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Japhter Masunge
Japhter Masunge
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Muireann Brennan
Muireann Brennan
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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Thomas Handzel
Thomas Handzel
Centers for Disease Control and Prevention, Atlanta, Georgia; BOTUSA Project, Gaborone, Botswana; Botswana Ministry of Health, Gaborone, Botswana
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In early 2006, coinciding with heavy rains, Botswana health facilities reported increases in diarrhea, mortality, and acute malnutrition among young children. Data on diarrhea, human immunodeficiency virus, feeding, mortality, and water/sanitation were collected by random cluster survey. Anthropometric data were measured and drinking water samples were tested. Of 537 surveyed children less than five years of age, one-third experienced ≥ 1 episode of diarrhea. Prevalence of acute malnutrition was 7.9%, and the mortality rate for children less than five years of age was 2.6/10,000/day during the outbreak. Significant risk factors for diarrhea included an age less than two years; breastfeeding was protective. Diarrhea lasting for more than 14 days and failure to thrive were risk factors for acute malnutrition. Prevalence of acute malnutrition was higher than previously documented and the mortality rate in children less than five years of age during the outbreak was above the international threshold for emergency action with an estimated 547 excess deaths. This survey highlights the need for safe infant feeding and effective treatment of malnutrition and diarrhea in young children.
Author Notes
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
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-
2
Boonstra E, Lindbaek M, Fidzani B, Bruusgaard D, 2001. Cattle eradication and malnutrition in under five’s: a natural experiment in Botswana. Public Health Nutr 4 :877–882.
-
3
Ismail S, 1991. Nutritional surveillance: experience from developing countries. Proc Nutr Soc 50 :673–679.
-
4
Grivetti LE, 1978. Nutritional success in a semi-arid land: examination of Tswana agro-pastoralists of the eastern Kalahari, Botswana. Am J Clin Nutr 31 :1204–1220.
-
5
UNDP, 2003. Human Development Report 2003. New York: Oxford University Press.
-
6
Lemeshow S, Robinson D, 1985. Surveys to measure programme coverage and impact: a review of the methodology used by the expanded programme on immunization. World Health Stat Q 38 :65–75.
-
7
Hoshaw-Woodard S, 2001. Description and Comparison of the Methods of Cluster Sampling and Lot Quality Assurance Sampling to Assess Immunization Coverage. Geneva: World Health Organization.
-
8
World Health Organization, 2005. The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. Fourth edition. Geneva: World Health Organization.
-
9
World Health Organization, 1995. Physical Status: The Use and Interpretation of Anthropometry. Geneva: World Health Organization.
-
10
American Public Health Association, American Water Works Association, Water Pollution Control Federation, 1980. Standard Methods for the Examination of Water and Wastewater. 15th edition. Washington, DC: American Public Health Association.
-
11
Olson B, Clark D, Milner B, Stewart M, Wolfe R, 1991. Total coliform detection in drinking water: comparison of membrane filtration with Colilert and Coliquick. Appl Environ Microbiol 57 :1535–1539.
-
12
Alam NHF, Rahaman MM, 1989. Reporting errors in one-week diarrhoea recall surveys: experience from a prospective study in rural Bangladesh. Int J Epidemiol 18 :697–700.
-
13
Ramakrishnan RVT, Koya PK, Kamaraj P, 1999. Influence of recall period on estimates of diarrhoea morbidity in infants in rural Tamilnadu. Indian J Public Health 43 :136–139.
-
14
Genser B, Strina A, Teles CA, Prado MS, Barreto ML, 2006. Risk factors for childhood diarrhea incidence: dynamic analysis of a longitudinal study. Epidemiology 17 :658–667.
-
15
Molbak K, Aaby P, Hojlyng N, da Silva AP, 1994. Risk factors for Cryptosporidium diarrhea in early childhood: a case-control study from Guinea-Bissau, West Africa. Am J Epidemiol 139 :734–740.
-
16
Rose JB, 1997. Environmental ecology of Cryptosporidium and public health implications. Annu Rev Public Health 18 :135–161.
-
17
Thomson MC, Mason SJ, Phindela T, Connor SJ, 2005. Use of rainfall and sea surface temperature monitoring for malaria early warning in Botswana. Am J Trop Med Hyg 73 :214–221.
-
18
Schmitt CV, 2006. Africa Weather Hazards Assessment February 2–8, 2006. Famine Early Warning System Network.
-
19
Leshomo K, 2006. Diarrhea Epidemic Leads to Threat of Severe Malnutrition in Botswana. New Yok: UNICEF.
-
20
Southern African Development Community Food Agricultural and Natural Resources Directorate, 2006. Agromet-Update: 2005/2006 Agricultural Season. Food Security Early Warning System.
-
21
Dop MC, 2002. Breastfeeding in Africa: will positive trends be challenged by the AIDS epidemic? [in French]. Sante 12 :64–72.
-
22
UNICEF, 2000. Botswana Multiple Indicator Survey. New York: The United Nations Children’s Fund.
-
23
Gracey M, 1996. Diarrhea and malnutrition: a challenge for pediatricians. J Pediatr Gastroenterol Nutr 22 :6–16.
-
24
The Sphere Project, 2004. Humanitarian Charter and Minimum Standards in Disaster Response. Geneva: Oxfam Publishing.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 325 | 230 | 6 |
| Full Text Views | 325 | 25 | 0 |
| PDF Downloads | 165 | 25 | 0 |